Program Operations Manual System (POMS)

A. Blindness—Initial Eligibility (334.1)

An individual is considered blind if he has central visual acuity of 20/200 or less
in the better eye with correcting glasses or a field defect in which the peripheral
field has contracted to such an extent that the widest diameter of visual field subtends
an angular distance of no greater than 20 degrees.

B. Permanent and Total Disability (344)

“Permanently and totally disabled” means that the individual has some permanent physical or mental impairment, disease,
or loss, or combination thereof, that substantially precludes him from engaging in
useful occupations within his competence, such as holding a job.

The following definitions clarify and delineate the concept of permanent and total
disability as regards to employment or homemaking.

1. PERMANENTLY

“Permanently” refers to a condition which is not likely to improve or which will continue throughout
the lifetime of the individual; it may be a condition which is not likely to respond
to any known therapeutic procedures, or a condition which is likely to remain static
or to become worse unless certain therapeutic measures are carried out, where treatment
is unavailable, inadvisable, or is refused by the individual on a reasonable basis;
“permanently” does not rule out the possiblity of vocational rehabilitation or even possible recovery
in light of future medical advances or changed prognosis; in this sense the term refers
to a condition which continues indefinitely, as distinct from one which is temporary
or transient.

2. TOTALLY

“Totally” involves considerations in addition to those verified through the medical findings,
such as age, training, skills, and work experience, and the probable functioning of
the individual in his particular situation in light of his impairment: an individual's
disability would usually be tested in relation to ability to engage in remunerative
employment: the ability to keep house or to care for others would be the appropriate
test for (and only for) individuals, such as housewives, who were engaged in this
occupation prior to the disability and do not have a history of gainful employment;
eligibility may continue, even after a period of rehabilitation and readjustment,
if the individuals work capacity is still very considerably limited (in comparison
with that of a normal person) in terms of such factors as the speed with which he
can work, the amount he can produce in a given period of time, and the number of hours
he is able to work.

3. EMPLOYMENT

The term “employment” refers to an activity in which a person engages on a full-time basis for financial
gain.

In determining whether an applicant is totally disabled for employment, his work experience
or his capacity for work must be considered. The disability decision must be based
upon an evaluation of the person's capacity for employment, considering his or her
impairment.

The disability decision about a male applicant is made from the standpoint of employment
or competition in the labor market. A single or lone woman is considered from the
standpoint of employment or competition in the labor market. A married woman who lives
in her family group is considered from that standpoint only if she has recent employment
experience which indicates that she would be employed if she did not have an impairment.

A person who is working as part of a training program is not “employed.” Such work activity may be in the person's own home, in a school, a sheltered workshop,
a factory, or other training setting. The determining factor is not the location of
the activity, but the presence or absence of supervision, a training goal or objective,
and the economic value of the item produced or service provided by the person.

Employment in a sheltered workshop, such as Goodwill Industries, usually is not considered
to be “employment” in the context of this section, even though such activity is not part of a training
program. One determining factor in such situation is whether the person is capable
of competing with nondisabled persons in the labor market.

Another determining factor is whether the person's employment activity in a sheltered
workshop involves production or service of real economic value, such as work on a
contract basis for private industry.

4. HOMEMAKING

The term “homemaking” refers to responsibility for making the decisions necessary for the management of
a home and family and for performing the duties necessary to carry out these decisions.
Homemaking is a full-time useful occupation which involves responsibility for at least
one person in addition to the applicant.

The essential functions of a homemaker, in addition to the decision-making responsibility,
are: planning and preparing meals, washing and ironing clothes, cleaning, shopping
for food and supplies, and training and caring for children.

A standard to be used in determining total disability for homemaking is the adequacy
of the woman's performance as a homemaker at the time she applies for ADP as compared
to the adequacy of her performance as a homemaker over a period of time prior to her
application. Other factors which must be considered are: whether any other persons
are performing the homemaking for the applicant, and the length of time required for
the applicant to perform the homemaking functions for herself and at least one other
person.